penisdoctor.com

January 12, 2012

Dear Dr. Reed,

A bit of an upset within the pro-circumcision community. Your name was mentioned as the exponent of a particular opinion concerning circumcision style. I’d like to check whether you have been correctly quoted.   It’s the old high/low debate again. The opposing factions are lined up thus:   One group is saying, in effect, that all circumcisions should be in the ‘high’ style (ample retention of inner foreskin) because (a) that is more sensitive and (b) subsequent conversion to a ‘low’ style is a possibility whereas the converse (conversion low-to-high) is not.   The opposing opinion is that the ‘low’ style (minimum retention of inner foreskin) should be contemplated on a “where appropriate to the objective” basis. This second group do not express disagreement with the tenets (a) and (b) of the first group, but go on from that point to reason thus: If retention of inner foreskin enhances sensitivity, then it follows that removal of inner foreskin should reduce it. Such reduction may be beneficial especially in instances where the objective is to increase what is sometimes termed ‘latency time’. An instance would be a problem of premature ejaculation.   So:   [A] Do you ALWAYS rule out ‘low’ styles, and if so… why?

Gary

Good morning Gary,

Thank you for your interesting questions.

My position is:

1.  For most man who practice good hygiene and are monogamous, a circumcision is not a medically necessary operation.  Can 350,000 years of human evolution be all that wrong?

2.  Pre-mature ejaculation is as commonly seen in circumcised as in uncircumcised men.  This is confirmed in our practice and my training is that no studies have shown otherwise.

3.  Large studies involving perhaps 20,000 cohorts of men (Kaiser Permanente Clinic in California), circumcised versus non, show no difference in penile sensitivity as a rule.  True if a doctor cuts inappropriately deep, there can be nerve injury.  In our practice we believe “a circumcsion is about removing skin.”

4.  The problem with very low circumcsion is that the circumference near the coronal sulcus or neck” is narrower versus the main portion of the shaft and marrying 2 circle or ellipses of unequal circumference can result in puckers in the larger circle, unless a V-cut or some other remedy is employed to reduce the larger circle.

5.  Moderation is always a good idea, although we try if possible to accede to patient request.

6.  For the present, I think we can agree circumcsion will continue for some to remain an emotionally  charged subject, contexted and laden with misrepresentation and exaggeration.

7.  Yesterday did an 11 week old boy with a  huge tubular umbilical hernia (its size, the  diameter of a garden hose and stuck out about 2 inches, 5 cm.).  The mother has been told to follow this expectantly as it might recede.  He also had a pin point phimosis that barely admitted the tip of a fine malleable rounded edge probe.  Surprised that he could urinate at all.

I didn’t believe for one second the umbilical hernia will go away, nor would the phimosis.  Did an uneventful circumcsion using a Mogen clamp.

Sincerely,

Harold M. Reed, M.D.

305-865-2000

Dr. Reed and Anne,   i cannot express how fortunate i consider myself for making you my choice when i decided to become circumcised.      Let me first say that i have lived 46 years ashamed and embarrassed because i felt different. I avoided relationships and abandoned a childhood dream of joining the military as i feared being nude in front of others. even after having the money for the procedure i was still reluctant because i was even ashamed of having to disrobe for medical professionals.                                                             After searching the internet for a local urologist/ surgeon i decided to call your office because of how informative your website was.           I first spoke with Anne,  who by the way was the first woman i have  ever  felt comfortable being nude in front of, a testament to her absolute professionalism. while prepping me for the procedure we talked as though we were in line at the supermarket.  For any one reading this and considering this procedure, i can tell you that there was zero ( ZERO ) pain involved at all, not even from the first injection to numb the area. Dr.Reed asked me continuously how i was doing, making sure i felt no pain. Even with sutures i was amazed by the transformation and how it good it looked after he was done.                                                                                                          What impressed my the most about Dr. Reed was when i  called telling him that i had managed to tear all of the  sutures on the bottom and now had a large scar. Most businesses as most of us know would rather not hear from you again after receiving payment, unless that is  there is more money to be made. The torn sutures was my doing, but Dr.Reed repaired it, made me feel as welcome as when we first met and the cost to repair the damage i had done probably would not cover the amount  of electricity it took do do it, truly some one who cares about his patients. THANK YOU Dr.Reed and Anne for giving me confidence that i have never before experienced and making me feel complete. please allow this letter to be read by all.                                                                                                  very sincerely ,   V.W.

July 31, 2011

Dear Dr. Reed,

 I had a circumcision about 5 months ago and it was not done neatly at all there are suture tracks, raised and sensitive spots and this 3 cm scar which looks like a incision that didn’t heal let when they put in the stitch I agreed to, I agreed to a straightening bendable stitch to be put inside of my penis to make it straight because of my downward curvature but they put it too close to the surface on top of my penis right below my head and the whole area keeps getting irritated and you can see one prong of the stitch through the skin and it looks terrible would i be able to get a revision and have the stitch inside of my shaft taken out or moved to the middle bottom of my shaft without leaving extra incision marks?
contact:     Nathan

Good morning Nathan,

Thank you for your excellent case presentation. Really sorry to hear that so many things have not worked out as you
anticipated. We would never close a penile curvature case without producing an erection in the operating room to be sure
it is straight. or meets with patient approval. Look at photographic examples of our circumcision results and see if this is more to your expectations.

The following is a letter we send to prospective concussion patients.   Might be of interest.

Thank you for your interest in what we do. Your penis is one of the most important cosmetic and functional features of your body.

We have performed over 6500 cosmetic circumcisions and revisions in the past 35 years and usually do several cases every week.

We have done sons of physicians, brothers, religious circumcisions, men who have not seen the heads of their penis for 20 years!  This is your circumcision and we do it the way you want with respect to 4 parameters.
 
Please don’t be like the patient done elsewhere who writes: “Dr. Reed I just got circumcised two days ago and my result was not what i expected. I was wondering when i recover can i get a consultation with you.” Photos sent and received (unspoken comment “disaster zone”)
 
Be assured we will show you every courtesy,
 
All the best,
 

Harold M. Reed, M.D.
305-865-2000

May 29, 2011

Had a circ last year in Baltimore. How do you explain some wrinkles I have in
my distal mucosal, or inner skin after circumcision. I thought they would go
away.

Lex

Hi Lex,

A circumcision is more than just an approximation of 2 fresh incisions. If the doctor doesn’t like what he sees or knowing how it’s going to look before he’s finished, it would not be very cosmetic to ignore that.

Underneath the loose skin of the penis are tissue septa or strands that limit the amount of stretching penile skin will undergo. On the soles of the feet, the septa are very short, somewhat looser on the palm, still looser on the back of the hand and much looser on the penis.

However, because of chronic inflammation the septa may yield just a little and so when the penile skin is on the stretch, they still are seen, creating little wrinkles.

The way we handle this is to undermine the septa and allow them skin to heal over the dartos fascia without wrinkles. If we see there is a potential for a penile scrotal web, we also free up the skin at the base of the penis on the underside, so it settles better. Please understand that this is our intention and no urologist can guarantee a perfect result, but we try to get as close as we can. We might be a little fussier, and that is why it is important to leave your dressing on for a good week, to immobilize the skin so it will heal with minimal scarring. 

For excesive wrinkled skin we may often removed a strip on the underside and close in the midline to provide a smoother look.

For this reason we prefer to have our patients watch work in progress with a hand held mirror to be sure, they are happy before the dressing is applied.

Harold M. Reed, M.D.
305-865-2000

May 26, 2011

Dr. Reed,

I had a Circ on 4/12/2011, the disolving sutures disolved after a week and a half, there is a opening a 1/4 inch on top and about 1/2 in on the right side its been open for the last month, my surgeon says it will close up, but after a month of being open I dont know if it will close up. do you think it will close up?

Tom

Good afternoon Tom,

This is a letter we send to prospective patients.

Taking one consideration with another, most probably you will
heal fine.  If you wish, I will review some photos and our phone
consult fee is 250.   Recommendations will be made to speed wound healing.

Here’s the letter… (again most probably you will heal fine)

Thank you for your interest in what we do.  Your penis is one of the most
important functional and cosmetic features of your body.

We have performed over 6000 cosmetic circumcisions and revisions
in the past 35 years and usually do several cases every week.

We have done sons of physicians, brothers, religious circumcisions,
men who have not seen the heads of their penis for 20 years! This
is your circumcision and we do it the way you want with respect
to 4 parameters.
 
Please don’t be like the patient who writes: “Dr. Reed I just got circumcised
(elsewhere) two days ago, and my result was not what i expected. I was
wondering when i recover can i get a consultation with you.” Photos sent
and received (unspoken comment: “disaster zone”)
 
Be assured we will show you every courtesy,
 
All the best,
 

Harold M. Reed, M.D.
305-865-2000

May 3, 2011

Hi Dr. Reed,

We spoke in August of last year regarding the tract marks that were left from my circumcision. Please read our emails below for a quick refresher.

I took your advice and went to see a dermatologist and explained the situation in its  full entirety. He gave me a cream called Dermovate  which is a steroid cream that I have to apply nightly. I don’t think this will help as it will not tackle the fact that the skin healed around the stitches creating tiny holes that seem to contain sebum sometimes. It seems to me that the only other way would be to excise the skin from the area.

How much would this procedure cost and how many days would I need to be in Miami for?

Also I have tiny Fordyce Spots on the shaft of my penis and would like them removed. I know they are not of any concern but for me I hate them. I have researched this tremendously and it seems the only method to tackle Fordyce Spots with a hyfrecator.   Do you do hyfrecatio treatments and if not can you recommend anyone to Hyfrecator these tiny Fordyce Spots.

These issues are affecting my sex life and as a young male who loves women, I really want them to get sorted.

Hope you guys are doing well in sunny Miami,

Kind Regards,
Dillon

Good morning Dillon,

Thank you for your update. Most likely we can do both if the Fordyce spots are not too extensive or clustered so that hyfrecation will leave a noticeable scar on the skin. As you know Fordyce spots are small sebaceous cysts unassociated with hair follicles.

Out fee for both is 1800 to include office consultation, local anesthesia, use of the operating room, and my followup care.

Plan on staying either at Daddy O’s Hotel or the Baltic as I will see you there daily for 2 post-operative days.

Please review the attached for general suggestions.

Sincerely,

Harold M. Reed, M.D.
305-865-2000

March 20, 2011

Dear Doctor Reed I was circumcised on 2/18/11 in CT and I know it didn’t come out right. My adult penis has averaged out about 1 1/4′ long when flaccid and about 5 3/4′ long when erect. It also used to point slightly up before the CC but it now has a hard time doing just that. Now my penis isn’t the same. The hairline that was against the base of the shaft is now midway up in the shaft when my penis is erect. I know the skin is holding back my erections because not only does it not feel like it but there is also a slight bulge near the base of the shaft whereas before the penis was wide at top and narrowed down toward pelvic bone. The scrotum is also really close to the shaft, weighing down my penis and thus changing how it points up during an erection. I think it can be fixed if I am re-circumcised and the skin is sewn farther away from the coronal ridge but again I am not sure. There is also a small piece of left over frenulum right under the meatus (urethra opening) and well all of this is depressing.   Manny

Good afternoon Manny,

Thank you for your interest in what we do. Usually, it is way too early to do a revision now. Most likely in 3 months. In the mean time please send some well focused photographs either by E-mail or in an envelope. Some
recommendations to promote optimal wound healing will be discussed during your consultation.

Please see examples of peno-scrotal web on http://penisdoctor.com/penoscrotal_web.htm

If I can help you, please then send us your name, phone number and address in an envelope along with a check for 250 as this is your one time charge for consultation fee.

We have performed over 6000 cosmetic circumcisions and revisions in the past 35 years and usually do several cases every week.

We have done sons of physicians, brothers, religious circumcisions, men who have not seen the heads of their penis for 20 years!   This is your circumcision and we do it the way you want with respect to 4 parameters.

Please don’t be like the patient who writes: “Dr. Reed I just got circumcised (elsewhere) two days ago, and my result was not what i expected. I was wondering when i recover can i get a consultation with you.” Photos sent and received (unspoken comment: “disaster zone”)

Be assured we will show you every courtesy,

All the best,

Harold M. Reed, M.D.
305-865-2000

February 1, 2011

I would like a revision with glans completely exposed. However, I am hopeful this is possible with some ‘movement’ left in the shaft – worried about too much tightness but currently dissatisfied with too sloppy of skin overhang. Is this a common concern? Can a balance be achieved?  Melodious Mel

February  2, 2011

Good morning Mel,

Thank you for your interest in what we do.  We will pre-mark you to suit and you will have a hand held mirror in the operating room to be 100% sure this is being done to your exact specifications.

We have performed over 6000 cosmetic circumcisions and revisions
in the past 35 years and usually do several cases every week.

We have done sons of physicians, brothers, religious circumcisions,
men who have not seen the heads of their penis for 20 years! This
is your circumcision and we do it the way you want with respect
to 4 parameters.
 
Please don’t be like the patient who writes: “Dr. Reed I just got circumcised (elsewhere) two days ago, and my result was not what i expected. I was wondering when i recover can i get a consultation with you.” Photos sent and received (unspoken comment “disaster zone”)
 
Be assured we will show you every courtesy,
 
All the best,
 

Harold M. Reed, M.D.
305-865-2000

what is the average wait time  for the  surgery  after one makes an appt.?  is the wait time  typically several months ?? less ? more ??  i  am interested  in BOTh  cirxcumsicion  and  vasectomy,,,  thanks  for  answering  my queries…  ps   can Dr. reed do  both  circumcision and  vasectomy same  day  ? if not,  what is  closest  amount  of  days apart  he’d be willing to do the  two procedures??  finally, emabarassing  to ask  this –but  during  procedures  is  one’s  penis  erect  due to  medications  injected  into  the  penis ??    Vladimir

Good morning Vladimir,

Yes, both can be done at the same time,.  If you are married,  a notarized letter of approval for vasectomy is required from your wife.   We do not produce an erection for circumcision,. but do put the penis on the strtetch to be sure we are not making it too tight.   Once tailor-tack sutures are put in, you will be given an opportunity to approve it is not too loose.
 
With kindest regards
Harold M. Reed, M.D.
305-865-2000

Dear Dr Reed,

First, thank you for getting back to me.  I was circumcised at birth. I have developed some scars underneath my corona that I would like to have removed. Additionally, I would like a tighter cut, maybe with my frenulum removed. Second, I don’t have any real problems with my penis or circumcision. I just want some cosmetic changes. Third, I have a few questions, if you don’t mind and have the time.

1. What are the “four parameters” you respect?
2. “Photos sent and received (unspoken comment ‘disaster zone’)” You mean, the pictures of the penises that you circumcised were ‘disaster zones’ before you circumcised them?
3. I’d never heard of a Japanese circumcision until I opened that document. What is it? What are the benefits?

Thank you,
Steve

November 21, 2010

Good morning Steve,

Thank you for your thoughtful questions which are answered in the order
posed…

1. What are the “four parameters” you respect? 

Firstly, I confer with the patient to find out exactly what type of result he is looking for: tight or loose, high or low, removal of the frenulum or preservation of the frenulum, and whether the cut be parallel to the corona (oblique) or perpendicular the shaft.  Secondly, only fine plastic surgery suture is used to create perfect alignment.  The patient has access to a hand held mirror in the operating room  to be sure the circumcision is being done according to his specifications.

2. “Photos sent and received (unspoken comment ‘disaster zone’)” You mean, the pictures of the penises that you circumcised were ‘disaster zones’ before you circumcised them?  

Thank you, as this is a little unclear and could even be construed that I was initially the operating surgeon.   This a letter from a patient who had been circumcised elsewhere and wasn’t happy with the result.  He sent me photos and later had a revision with me.

3. I’d never heard of a Japanese circumcision until I opened that document.  What is it? What are the benefits?

Please avoid this as the cut is made towards the base of the pubis and all of the foreskin is saved.  Problem is this results in a lot of swelling of the shaft which may take months to resolve.    I am not saying that this is the way all circumcisions are performed in Japan, but this is the appelation was given to me by the patient which is also described on the web.

Have a restful Sunday,

Harold M. Reed, M.D.
305-865-2000